A varicocele is when a vein becomes enlarged inside the scrotum. These veins are referred to as the pampiniform plexus. Ten to 15 of every 100 males will develop a varicocele. It is similar to a varicose vein in the leg. Varicoceles are more frequent on the left side of the scrotum because the veins on the left are not connected in the same way and blood requires more pressure to be pumped through them. Varicoceles can be found on both sides simultaneously, however this is rare. Usually, varicoceles do not cause problems and are typically harmless. Less often varicoceles can cause discomfort, problems with infertility, or a testicle to grow slower or shrink.
A man’s reproductive system creates, houses, and moves sperm. Sperm mature when flowing through a coiled tube, known as the epididymis, behind each testicle. Sperm travel to the prostate from each epididymis via the vas deferens. The spermatic cord encases the vas deferens and the testicular artery, which circulates blood in the testicle, and also houses the pampiniform plexus, the group of connected veins which drains blood from the testicles. When the blood pools or slows in the pampiniform plexus, it can cause it to enlarge hindering circulation in the surrounding veins and arteries.
Several males with a varicocele don’t have symptoms. However, varicoceles are a concern for different reasons. They can cause infertility and slow growth of the left testicle during puberty. Varicoceles are the cause of fertility problems in roughly 4 out of 10 men who have issues fathering a first child. They can also be the cause of fertility issues in roughly 8 out of 10 men who have problems fathering additional children.
Frequently, varicoceles are not treated. Treatment is provided for males who have:
Boys with smaller left testicles are believed to have an increased risk for fertility issues when they grow up. There are no medications to treat or prevent varicoceles however pain relievers including acetaminophen or ibuprofen can assist with pain. When required, surgery is the preferred form of treatment. Embolization, momentarily blocking the veins, is a non-surgical treatment option which can be used as well.
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